SECTION-I

Important Text
&
MCQs Chapterwise Arranged

CHAPTER
m

m
m
m

General Psychiatry

Mental health is a state of psychological well

being or adequate adjustment, particularly as such
adjustment conforms to the community accepted
standards of behaviour.
Psychoanalysis is a form of procedure (for investigating mental processes), a theory and a form of
treatment developed by Sigmund Freud.
Average prevalence of severe mental disorders in
India is 18-20/1000 population.
Average incidence of serious mental disorders is
35 per lac population
About 1-2% of children suffer from learning and
behaviour problems.

Mental retardation is estimated to be present in

0.5-1.0% of all children.
m Depressive neurosis is the most frequent psychiatric disorder in India (Neuroses constitute about
two third cases), followed by anxiety neurosis.
Depression is the commonest geriatric
psychiatric problem (i.e. 60/1000)
m Schizophrenia utilizes most of the psychiatric
beds available in India.
m In India, we have about 2000-2500 qualified
psychiatrists, 600-700 psychologists, 300-400
psychiatric social workers and 500-600 psychiatric
nurses.

Important Characteristics of Mental Health

Reasonable independence
Self-reliance
Self-direction
Ability to do a job
Ability to take responsibility and
make needed efforts
Reliability
Persistence
Ability to find recreation, as in hobbies
Satisfaction with sexual identity
Ability to work under authority,
rules and difficulties
A sense of competition, collaboration
compromise satisfaction and security

Ability to show friendliness and love

Ability to give and take
Tolerance of others and of frustration and
emotions
Ability to contribute
A sense of humor
A devotion beyond oneself
Ability to get along with others
(capacity for intimacy)
Cooperation
Optimism
Ability to function in both dependent and
independent roles

Psychiatry Review

MCQs
1. The number of new cases of serious mental
disorders which become manifest each year
(incidence) per lac population is approximately:
A. 5
B. 10
C. 25
D. 35
2. The commonest psychiatric illness in world is:
A. Schizophrenia
B. Endogenous depression
C. Anxiety neurosis D. Exogenous depression
3. The commonest psychiatric disorder among elderly
in India is:
A. Dementia
B. Delirium
C. Depression
D. Suicide
4. Ethology is:
A. Studying of interaction between animals and
human being
B. Study of animal behaviour in natural habitat
C. Study of animals under controlled laboratory
conditions
D. None of the above
5. The following psychiatric disorders are more
common in females except:
A. MDP depression B. Transvestism
C. Social phobia
D. Anorexia nervosa
6. Ethology has made major contributions to understand human behaviour through all the following
concepts except:
A. Fixed action pattern and sign stimulus
B. Critical period
C. Ethnic bonds
D. Imprinting
7. Estimated prevalence of neurosis in the community
is about:
A. 05%
B. 510%
C. 1020%
D. 2040%
8. Number of cases of psychoses expected per
thousand population:

A. Less than one

B. 15
C. 610
D. 1120
9. Mental disorders are:
A. Adaptive and Reparative
B. Protective
C. Defensive
D. All of the above
10. A psychiatric illness may be marked by all of the
following except:
A. Disturbance in behaviour
B. Impairment in preexisting functioning
C. Impoverishment of feelings
D. Unpopular beliefs
11. Epileptic fit and hysterical fit can be certainly
differentiated by:
A. Duration of fit
B. Frothing from mouth
C. Incontinence of urine
D. Injury during fit
12. The commonest mental illness in children is:
A. Mental retardation B. Infantile autism
C. Enuresis
D. Neuroses
13. Prevalence of mentally ill patients in India is at
least:
A. 15/1000
B. 510/1000
C. 1020/1000
D. 100200/1000
14. The commonest psychotic illness in India is:
A. Schizophrenia
B. Endogenous depression
C. Mania
D. Dementia
15. Commonest psychiatric illness in India is:
A. Schizophrenia
B. Endogenous depression
C. Mixed Anxiety Depressive Disorder
D. Anxiety neurosis
16. The prevalence of severely mentally retarded in
India is:
A. 12/1000
B. 510/1000
C. 1015/1000
D. 1520/1000

ANSWERS
1. D
11. C

2. C
12. D

3. C
13. C

4. B
14. B

5. B
15. C

6. C
16. A

7. B

8. B

9. D

10. D

CHAPTER
m

m
m
m

History of psychiatry

Sigmund Freud (1856-1939): Austrian psychiatrist,

Founder (father) of Psychoanalysis, gave
topographical theory of mind (unconscious,
preconscious and conscious) and its structure (Id,
Ego, Supergo); described stages of psychosexual
development (oral anal, phallic (oedipal), latent
and genital); oedipal complex; Interpretation
of dreams; concepts of libido, regression,
transference, sublimation and repression; took and
described properties of cocaine.
Alfred Adler (1875-1937): Austrian psychiatrist,
gave concepts of inferiority complex (superiority
drive), overcompensation and founded school of
Individual Psychology.
Carl Gustav Jung (1875-1961): gave concepts of
Collective unconscious, archetypes, personality
types (introvert and extrovert), anima animus,
persona and founded school of analytic psychology.
Philipe Pinel is known as the father of modern
psychiatry (he founded humane approach for
treating mentally-ill persons)
Felix Platter wrote the first psychiatric textbook
(Praxis Medica)
Johann Reil first used the word psychiatry
whereas Gockel coined the word psychology.
Julius Wagner von Jauregg was first
psychiatrist to get Nobel Prize for malarial
therapy of GPI.
First drug introduced in psychiatry : among
Major
tranquilizers
or
antipsychotics
(chlorpromazine), butyrophenones (haloperiodol),

antidepressants (iproniazid, a MAOI), benzodiazepines (chlordiazepoxide).

m Atreya was the first great Indian Physician.
m First Asylum in India was built in Bombay.
m Indian Lunacy Act (1912) has been replaced by
Mental Health Act (of 1987); Narcotic Drugs
and Psychotropic Substances Act was passed
in 1985 and National Mental Health
Programme was launched in 1982.
Some Contributors to the Development of
Therapies
I. Organic Therapies
W. Oliver (1785)
Camphor induced convulsions in Melancholia
Wagner von Jauregg Malarial treatment in
(1917)
General Paresis of Insane
Kalesi (1922)
Prolonged Narcosis
therapy
Steck (1932)
First used insulin in acute
Psychosis
Sakel (1933)
Insulin Coma therapy
Meduna (1930s)
Cardiazol or Metrazol
convulsive therapy
Friedman and Wilcox Unilateral Electroconvulsive
(1942)
therapy
P. Dalmas-Marsolet Continuous stimulation
(1942)
therapy
Egas Moniz (1936) Psychosurgery (Perfrontal
lobotomy) and also carotid
Angiography

Psychiatry Review

Schulte (1950)
Fiamberti (1937)
Lovenhart et al
(1926)
Hoch (1930s)
Kielholz

Sleep deprivation therapy

Acetylcholine
Carbon dioxide Therapy

Atropine therapy
Blood transfusion and
hemodialysis for treatement
of mental illness
Deschamps (1952) Artificial hibernation
(Refrigeration therapy)
Talbot and Tillotson Hypothermia
Cossa and Gastuat Photoshock therapy
Delay et al
Cerebral Pneumotherapy
(Suboccipital)
Blackwenn
Narcotherapy (Using
Sodium Amytal)
Kane and di Scipio Acupuncture in mental
illness
Cerletli
Acroagonine (a substance
which appears after ECT
in brain) therapy
Zador (1928)
Nitrous Oxide inhalation
therapy
Sargant and Slater Ether Abreaction therapy
II. Psychological Therapies
Sigmund Freud
Psychoanalysis and Free
association.
Carl C. Rogers
Client Oriented Psychotherapy
Frederich Perls
Gestalt therapy.
Erich Berne
Transactional analysis
Victor E. Frankl
Existential logotherapy
James Braid
Neuro-hypnotism
Albert Ellis
Rational Emotive therapy
William Glasser
Reality therapy
Arthur Janov
Primal therapy
J.L. Moreno
Psychodrama
Assagioli
Psychosynthesis
Maslow
Self Actualization
Pietro Pisani
Millieu therapy
Aaron Beck
Cognitive therapy (in
depression)
T.F Main and
Therapeutic communities
Maxwell Jones
John Watson
Behaviorism

Ivan Pavlov

Joseph Wolpe

B.F. Skinner

Joint commission on
Mental Illness (in USA)

Classical conditioning
Systematic desensitization
Operant conditioning
Deinstitutionalization.

Some Contributors to the Development of

Drug Treatment
Hippocrates

Herbal remedies for mental

illness
Fisher (1903)
Synthesized first barbiturate
Sen and Bose (1931) Used rauwolfia extract in
major Psychosis
Bernthsen (1883)
Synthesized chlorpromazine
Charpentier (1950)
Described properties of
chlorpromazine
Delay, Deniker and
Use of chlorpromazine to
Harl (1952)
treat certain psychotic
symptoms and coined term
Neuroleptic
Cade (1949)
Lithum
Zeller (1952)
Described Iproniazid
(a MAO inhibitor) as an
antidepressant
Janssen et al (1958)
Synthesized large number
of butyrophenones
Divry et al (1958)
Described properties of a
number of butyrophenones
Kuhn (1957)
Described properties of
imipramine
Haflinger and Schindler Synthesized imipramine
(1957)
Sternbach
Discovery of chlordiazepoxide
Cohen (1960)
Described properties of
chlordiazepoxide
Hoffer and Osmond
Megavitamin
therapy
(1954)
(niacin + Vit.C + Penicillin)
Hald et al (1948)
Disulfiram (antabuse)
Ferguson (1956)
Calcium carbide cause
reaction like antabuse
Taylor et al (1964)
Metronidazole
causes
Antabuse like reactions
Osterman et al (1959) Chlormethiazole (used in
alcohol withdrawal
symptom)

History of Psychiatry

MCQs

1. The word Social Psychiatry was coined by:

A. Franz Alexander
B. S.R. Slavson
C. Thomas Rennie
D. Konrad Lorenz
2. Match the following:
I. Cade
(i) Chlorpromazine
II. Cohen
(ii) Chlordiazepoxide
III. Hoffman
(iii) Lithium
IV. Delay and Deniker (iv) Lysergic acid
A. I (ii)
II (iii) III (iv) IV (i)
B. I (i)
II (ii) III (iv) IV (iii)
C. I (iii) II (ii) III (iv) IV (i)
D. I (iii) II (iv) III (ii) IV (i)
3. Match the following:
Stage of Psychosocial
Conflict
Development
I. Oral
(i) Autonomy versus
shame
II. Anal
(ii) Initiative versus guilt
III. Genital
(iii) Industry versus
inferiority
IV. Latent
(iv) Trust versus mistrust
A. I (i)
II (ii)
III (iv) IV (iii)
B. I (iv)
II (ii)
III (i)
IV (iii)
C. I (iv)
II (i)
III (ii) IV (iii)
D. I (iv)
II (iii)
III (ii) IV (i)
4. Hallucination is a perception without a stimulus
(false perception) was said by:
A. Bleuler
B. Janet
C. Schneider
D. Esquirol
5. Which of the following is a topographical model of
mind by Freud:
A. Id-Ego-Superego
B. Unconscious-Preconscious-Conscious
C. Regression-Repression-Suppression
D. Denial-Rationalization-Projection
6. The definition of hallucination It is a false
perception, which is not a sensory distortion, or
misinterpretation but which occurs at the same
time as real perceptions, was given by:

A. Esquirol
B. Jaspers
C. Bleuler
D. Schneider
7. Who has been often called as the First
Psychiatrist:
A. Paracelsus
B. Hippocrates
C. John Weyer
D. Sigmund Freud
8. Match the following:
I. Morselli
(i) Hypnosis
II. James Baird
(ii) Schizoaffective
III. Kahlbaum
(iii) Dysmorphophobia
IV. Kasanin
(iv) Paranoia
A. I (ii)
II (iii)
III (iv)
IV (i)
B. I (i)
II (ii)
III (iii)
IV (iv)
C. I (ii)
II (i)
III (iii)
IV (iv)
D. I (iii)
II (i)
III (iv)
IV (ii)
9. The term Ambivalence was coined by:
A. Hippocrates
B. Eugen Bleuler
C. Kraepelin
D. Sigmund Freud
10. God complex-a belief sometimes in therapists that
one, can accomplish more than is humanly possible
or that ones word should not be doubted, was first
discussed by:
A. Sigmund Freud
B. Erik Erikson
C. Joseph Breuer
D. Ernest Jones
11. Match the following:
I. Clifford Beers
(i) Psychopathia sexualis
II. Otto Rank
(ii) Major studies of
Luther and Gandhi
III. Eril Erikson
(iii) A mind that found
itself
IV. R. Kraft Ebing
(iv) The trauma of birth
A. I (i)
II (ii)
III (iii) IV (iv)
B. I (ii)
II (iii)
III (iv) IV (i)
C. I (iii)
II (iv) III (ii) IV (i)
D. I (iii)
II (ii)
III (iv) IV (i)
12. The term Style of life was coined by:
A. Sigmund Freud
B. Alfred Adler
C. Karen Horney
D. Eric Berne

13. The concept of Experimental Neurosis was given

by:
A. Sigmund Freud
B. Karen Horney
C. Ivan P. Pavlov
D. Frederic B. Skinner
14. The first of the benzodiazepines, synthesized in 1957
was:
A. Diazepam
B. Chlordiazepoxide
C. Chloral hydrate
D. Lorazepam
15. All of the following are Neo-Freudians except:
A. Anna Freud
B. H.S. Sullivan
C. Melanie Klein
D. Erik Erikson
16. The important work The Ego and the Mechanisms
of Defense is attributed to:
A. Sigmund Freud
B. Anna Freud
C. Alfred Adler
D. Carl C. Jung
17. First mental hospital was founded in:
A. USA
B. UK
C. Spain
D. France
18. First mental hospital was said to be founded by:
A. Juan C. Duarte
B. Gilbert Jofre
C. Philippe Pinel
D. William Tuke
19. The term therapeutic community was introduced
by:
A. Charles Dederich B. Tom Main
C. Maxwell Jones
D. Cliford Beers
20. In Freudian theory, Oedipus complex is seen in
which stage of the psychosexual development:
A. Anal
B. Urethral
C. Genital
D. Latent
21. Match the following:
I. Esquirol
(i) Pseudohallucinations
II. Hagen
(ii) Apperceptive
hallucination
III. Kahlbaum
(iii) Pale hallucinations
IV. Griesinger
(iv) Hallucination
A. I (i)
II (ii)
III (iii) IV (iv)
B. I (iii)
II (iv) III (i)
IV (ii)
C. I (iv)
II (i)
III (ii) IV (iii)
D. I (iv)
II (ii)
III (iii) IV (i)
22. All of the following are the characteristics of
hypnagogic hallucinations except:

Psychiatry Review

A. Occur during drowsiness

B. Are discontinuous
C. Appear to force themselves on the subject
D. Form a part of an experience in which the
subject participates
23. Sigmund Freud is famous for:
A. Structure of brain

B. Inferiority complex

C. Behaviour therapy D. None of the above

24. Oedipus complex (given by Sigmund Freud) is seen
in:
A. Boys of 13 years of age
B. Girls of 13 years of age
C. Boys of 35 years of age
D. Girls of 35 years of age
25. Life span of Sigmund Freud was:
A. 18361919

B. 19461929

C. 18561939

D. 18651934

26. Sigmund Freud passed most of his life in:

A. USA

B. Germany

C. Austria

D. France

27. Defect of conation is typically seen in:

A. Simple schizophrenia
B. Hebephrenic schizophrenia
C. Catatonic schizophrenia
D. Paranoid schizophrenia
28. Auditory hallucinations in clear consciousness is
seen in:
A. Senile dementia
B. Multiinfarct dementia
C. Alcoholic hallucinosis
D. Alcoholic intoxication
29. Which of the following is a wrong matching:
A. Waegner-Malaria treatment in GPI
B. Meduna-Convulsive therapy
C. Sakel-Insulin coma
D. Adler-Superiority complex
30. Body-Mind dualism, was written by:
A. Pierre Janet

B. Sullivan

C. Anna Freud

D. Rene Descartes

History of Psychiatry

31. Match the following:

I. Hallopeau

(i) Babel of Tongues

(Problems in communicating among
psychiatrists)
II. Pinel and Esquirol (ii) Kleptomania
III. Marc
(iii) Instinctive monomania
IV. William Meninger (iv) Trichotillomania
A. I (ii)
II (iii)
III (iv) IV (i)
B. I (iii)
II (iv) III (ii) IV (i)
C. I (iv)
II (iii)
III (ii) IV (i)
D. I (iv)
II (i)
III (ii) IV (iii)
32. Match the following:
I. Gockel
(i) First mental hospital in
Valencia
II. Paolo Zacchia
(ii) First Psychiatric book
(Praxis Medica)
III. Felix Platter
(iii) Father of legal
medicine
IV. Gilbert Jofre
(iv) Coined word
Psychology
A. I (i)
II (iv) III (iii) IV (ii)
B. I (ii)
II (i)
III (iv) IV (iii)
C. I (iii)
II (ii)
III (i)
IV (iv)
D. I (iv)
II (iii)
III (ii) IV (i)
33. Which of the following is not a contribution of
Sigmund Freud:
A. Effects of cocaine
B. Interpretation of dreams
C. Psychosexual stages of development
D. Superiority-Inferiority complex
34. First antipsychotic drug introduced was:
A. Chlorpromazine
B. Haloperidol
C. Trifluoperazine
D. Lithium
35. The latency phase of psychoanalytic theory occurs
at the same time at which of the following
Eriksons stages?
A. Trust vs mistrust
B. Identity vs role confusion
C. Industry vs inferiority
D. Autonomy vs shame & doubt

36. Match the following:

I. Oral stage
(i) Shame, ambivalence
and personal achievement
II. Anal stage (ii) Tendency and autoeroticism
III. Genital stage (iii) Swings between asceticism,
eroticism and altruism
IV. Latency
(iv) Strong patterning after
heroes and limited sexual
curiosity
V. Puberty
(v) Castration complex develop
A. I (i)
II (ii)
III (iii) IV (iv) V (v)
B. I (ii)
II (i)
III (v) IV (iv) V (iii)
C. I (ii)
II (iii)
III (iv) IV (v) V (i)
D. I (iii)
II (iv) III (v) IV (i)
V (ii)
37. Match the following:
I. Bibring
(i) Depression, is a
conflict within ego
rather than between
ego and super-ego is
associated with loss of
self-esteem
II. Abraham
(ii) Melancholia is a
despairing cry for love
III. Melanie Klien
(iii) Inability to solve the
normal depressive
position leads in later
life to depression
IV. Sigmund Freud
(iv) In mania-there is
fusion of ego and
super ego while in
melancholia, there is
an incorporation of
ambivalently loved lost
object
V. Rado
(v) Compared melancholic
depression with grief
A. I (i)
II (v)
III (iii) IV (iv) V (ii)
B. I (i)
II (ii)
III (iii) IV (iv) V (v)
C. I (ii)
II (i)
III (v) IV (iii) V (iv)
D. I (i)
II (v)
III (iv) IV (iii) V (ii)
38. Moral treatment of mentally ill patients was first
stressed by:
A. Pinel
B. Morel
C. Kraepelin
D. Sigmund Freud

10

39. The classification of hallucinosis into confusional,

self reference, verbal and fantastic was given by:
A. Jaspers
B. Sedman
C. Hagen
D. Schroeder
40. Pick up wrong matching:
A. Freud - Cocaine
B. Cade - Lithium
C. Adler - Imipramine
D. Cerletti and Bini - ECT
41. Oedipus complex is seen in:
A. A male child towards mother
B. A female child towards mother
C. Mother towards male child
D. Mother towards female child
42. Delusion is a disorder of:
A. Cognition
B. Conation
C. Will
D. Affect
43. Freud was born in:
A. 1836
B. 1856
C. 1896
D. 1902
44. Elektra (Electra) complex a term first used by:
A. Sigmund Freud
B. Anna Freud
C. Janet
D. Melanie Klein
45. Which of the following types of ambivalence was
not given by Bleuler:
A. Ambivalence of will
B. Ambivalence of thinking
C. Affective ambivalence
D. Ambivalence of act
46. Pavlov is associated with:
A. Operant conditioning
B. Classical conditioning
C. Inferiority complex
D. Habit disorders
47. Pick up wrong matching:
A. Freud - Cocaine
B. Delay & Deniker chlorpromazine
C. Kuhn - Imipramine
D. Janssen - Haloperidol
48. Pick the wrong match:
A. Phillipe Pinel - Psychiatric reforms
B. Emile Kraepelin - Early study of schizophrenia
C. Sigmund Freud - Dream analysis
D. Joseph Wolpe - Test of intelligence

Psychiatry Review

49. Match the following classifications and authors:

I. Dimensional
(i) Pavolv and Skinner
II. Typological or
(ii) International
categorical
Classification of
Diseases (ICD-9),
WHO
III. Multiaxial
(iii) Rutters
IV. Behavioural
(iv) Eysenck
A. I (i)
II (ii)
III (iii) IV (iv)
B. I (iii)
II (ii)
III (i)
IV (iv)
C. I (iv)
II (ii)
III (iii) IV (i)
D. I (iv)
II (iii)
III (ii) IV (i)
50. All of the following were Post-Freudians (Human
Potential Movement or Growth therapies) except:
A. Winnicot
B. Erikson
C. Carl Rogers
D. Bowlby
51. All of the following were said to be Neo-Freudians
except:
A. Horney
B. Anna Freud
C. Melanie Klein
D. Eric Berne
52. Theory of control and communication between man
and machine is :
A. Primal therapy
B. Existential logotherapy
C. Basic Encounters D. Cybernatics
53. First Neurotransmitter discovered was:
A. Norepinephrine
B. Dopamine
C. Serotonin
D. Acetylcholine
54. Sigmund Freud opined that Religious ideas are:
A. Delusions
B. Overvalued ideas
C. Illusions
D. Hallucinations
55. According to Sigmund Freud, all of the following
are the Egos defence mechanisms except:
A. Restitution
B. Reversal
C. Regression
D. None of the above
56. Superego differs from the conscience in that :
A. It belongs to a different frame of reference i.e.
metapsychology not ethics.
B. It includes unconscious elements
C. Injections and inhibitions emanating from the
subjects past and may be conflict with his
present values
D. All of the above